Boils

What are boils?

Boils are painful, pus-filled bumps that form under the skin when bacteria infect one or more of the hair follicles. Boils usually start as red, tender lumps. The lumps quickly fill with pus, growing larger and more painful until they rupture and drain. Although some boils disappear a few days after they occur, most take about 2 weeks to heal. Boils can occur anywhere on the skin, but appear mainly on the face, neck, armpits, buttocks or thighs - areas where one is most likely to sweat. Sometimes boils occur in clusters called carbuncles. Although anyone can develop these painful infections, people in poor general health or with medical conditions such as acne and diabetes are at increased risk.

What are the symptoms?

A boil usually appears suddenly as a painful pink or red bump about 1/2 inch in diameter. The surrounding skin may also be red and swollen. Within 24 hours, the bump fills with pus. It grows larger and more painful for 5 to 7 days before it develops a yellow-white tip that finally ruptures and drains. Boils generally clear completely in about 2 weeks. Small boils usually heal without scarring, but a large boil may leave a mark.

What are the causes?

Boils usually form when one or more hair follicles - the tube-shaped shafts from which hair grows - become infected with staph bacteria (Staphylococcus aureus). These bacteria, which normally inhabit the skin and sometimes the throat and nasal passages, are responsible for a number of serious diseases, including pneumonia, meningitis, urinary tract infections and endocarditis - an infection of the lining of the heart. They're also a major cause of hospital-acquired infections and food borne illnesses.

What are the risk factors?

Although anyone - including otherwise healthy people - can develop boils, the following factors can increase your risk:

• Poor general health. Having chronic poor health makes it harder for the immune system to fight infections.
  
• Diabetes. This disease also makes it more difficult for the body to fight infection. In fact, recurrent boils sometimes may be a symptom of diabetes, especially in people older than 40.
  
• Clothing that are tight. The constant irritation from tight clothing can cause breaks in the skin, making it easier for bacteria to enter the body.
  
• Other skin conditions. Because they damage the skin's protective barrier, skin problems such as acne and dermatitis make one more susceptible to boils and carbuncles.
  
• Immune-suppressing medications. Long-term use of corticosteroids such as prednisone or other drugs that suppress the immune system can increase the risk.

What are the complications?

In some cases, bacteria from a boil can enter the bloodstream and travel to other parts of the body. The spreading infection, commonly known as blood poisoning (septicaemia), can rapidly become life-threatening. Initially, blood poisoning causes symptoms such as chills, a spiking fever, a rapid heart rate and a feeling of being extremely ill. But the condition can quickly progress to shock, which is marked by falling blood pressure and body temperature, confusion, clotting abnormalities and bleeding into the skin.

What is the treatment?

The doctor may drain a large boil or carbuncle by making a small incision in the tip. This relieves pain, speeds recovery and helps lessen scarring. Deep infections that cannot be completely cleared may be covered with sterile gauze so that the pus can continue to drain. Sometimes the doctor may prescribe antibiotics to help heal severe or recurrent infections.

Home care

The following measures may help the infection heal more quickly and prevent it from spreading:

• Apply a warm cloth to the affected area for approximately 30 minutes every few hours. If possible, soak the cloth in warm saltwater, which helps the boil rupture and drain more quickly.
  
• Gently wash the boil twice a day, apply an over-the-counter antibiotic and cover with a bandage.
  
• Never squeeze a boil - this can spread the infection.
  
• Wash your hands thoroughly after treating a boil and clothing that have touched the infected area.

What is the prevention?

Although it is not always possible to prevent boils, especially if one has a compromised immune system, the following measures may help infections:

• Thoroughly clean even small cuts Wash well with soap and apply an over-the-counter antibiotic ointment
  
• Avoid constricting clothing Tight clothing should be avoided.
  
• Eat a healthy diet Eat a healthy diet including whole grains, fresh fruits and vegetables.